Tuesday, 15 February 2011

The Middle Classes & Mr Clarke's Uncomfortable Truth

Since the Blair-Brown spending spree kicked in, any educated middle-aged, middle-class lady at a loose end was able to become a ‘manager’ in the NHS. No formal qualifications, and rather little training required.

Just in case any of them are reading, to put ‘manager’ in inverted commas is not to diss the many ladies of my acquaintance who have followed this course: rather to indicate that the ‘programmes’ they run are, how shall we say, not always delivering bedrock healthcare necessities as would have been understood by Bevan, Bevin or Beveridge.

It’s not just the NHS. Who are the legions of small-firm solicitors who have fed off legal aid in pursuit of fatuous causes ? Of social workers who ensure that all manner of newly-minted ‘human rights’ are delivered ? Middle-class ladies, that’s who.

In other words, as government spending has soared out of control providing all manner of ‘services’ that could not really be described as adding to the GDP of the nation (or even, frankly, its well-being as properly understood), and though the ‘clients’ are frequently of the hoi polloi, as a cash transfer it has been significantly in favour of middle class ladies.

Which means that legal aid slasher Ken Clarke is indeed correct when he says that Middle England has yet to see the full force of what’s coming: disposable income in many a middle-class household is going to plummet - even if the Spectator thinks this is “one of those truths that should go unsaid”.

And for every protesting voice of a ‘client’ who is about to lose his or her service in t’Cutz, there will be another, rather more articulate voice of the about-to-be axed service-provider. The Budget could be very interesting.

The vast majority of legal aid was privatised years ago, hence why most people can now afford to bring an action when they get done over.

The only gaping messes left in it are "who gets criminal legal aid" and the awful situation that if you are a proper granny bashing criminal the taxpayer picks up the tab for your defence whereas if you are getting the frighteners put on by, a vindictive local cop shop or council or the raggedy arsed CPS looking for easy meat, then not only do you fund yourself but if you win you can't recover the cost from the buggers that tried to do you in in the first place.

Yes, I know the type: issued with an expensive NHS laptop; hardly there (I'll just be a little late in this morning); when she is in it is always for 'meetings'; nice; decent; incompetent. At the PCT only a couple of pharmacists and office dogsbodies did anything constructive - and even that could have been done by the GPs.

Not sure about your NHS middle management argument. From what I've seen of it through family members, the NHS pay too little to get many really good middle managers. Take a look at the Agenda for Change pay scales bands:

Band 4: £18,152 - £21,798 General Office Manager

Band 5: £21,173 - £27,534 Project Support Manager, Business Manager

Band 6: £25,472 - £34,189 Manager Higher Level, Project Manager

From my experience these are not competitive with good private sector managers. What do you think? I suspect the salaries are pitched at a level that appeals mainly to second earners returning to the workforce.

Compare that to managers on the medical side, that generally seem pretty well paid:

Since the Blair-Brown spending spree kicked in, any educated middle-aged, middle-class lady at a loose end was able to become a ‘manager’ in the NHS. No formal qualifications, and rather little training required.

I fear your analysis may well be flawed. Firstly, save only perhaps for the banking community (which seems insulated from just about anything which befalls our God forsaken country) the middle classes are already and will continue to suffer from the insane fiscal and monetary polices of this country. New Labour's Gramscian policies may well have created a few job opportunities for some middle class housewives (in distinction from the hordes of other jobs they created for the other classes including the legions of consultants and banker/financiers (the latter group's jobs were not only created by monetary incontinence but saved by it as well). But there lies the rub. Getting rid of what you may consider non-jobs may well prove more difficult than you think when the positions themselves may well be a legal requirement. I well remember a few years ago my local council advertising such non-jobs in my local paper. I was compelled to ring the head of the relevant department who was absolutely charming but had the brass neck (when I indicated what a waste of money the posts represented) to tell me show would have preferred to double her head count.

On a personal note, my professionally qualified and ferociously intelligent partner, was recruited into the public sector during the height of New Labour's job fest. The nature of her work, and the fact that she works around seventy hours a week for a tenth of the private sector equivalent, is an indictment of the whole politico-legal system which I can assure will not be changed by this gutless spiteful government.

BE, Sumo - but recently I saw the stats on UK legal aid (£ per head of pop) vs other countries that would be a fair comparator (e.g. Germany) and we dish out far, far more - or has this stopped in the last few months?

BTW I'd have no complaints about sorting the CPS, Sumo

hovis - yes, opens up into a big topic. Social engineering responsibilities laid on NHS & schools is another

budgie, jim - yes indeed, if only the unproductive numbers could be weeded out (some of these non-jobs remind one of French state 'enterprises), BUT that wasn't quite my point in the post ...

ND But isn't the correct conclusion that the NHS should pay more to middle managers, to improve effeciveness and general efficiency? Rather contrary to the usual daily mail-type narrative on the NHS.

From what I indirectly see, in a 40-odd clinical dept, including many clinicians earning near £100k, admin (making appointments, chasing up patients, contacting GPs and schools, writing medical reports, etc) is run by a Band 4 manager earning around £21k, and staffed by admin workers earning less. If they don't run appointments, referrels etc well the whole dept efficiency drops. My observation of the NHS is that they actually over-rely on the dedication of low paid admin staff, and I'm not sure that will survive yet more changes. In fact my observation is that it is the willingless of some "middle-aged, middle-class ladies" to work at lower than market pay that keeps a some of the NHS going. But maybe elsewhere in the NHS, like London, it is different.

anon - we have often advocated gaol for the banksters in these columns, and bemoaned the NuLab consultancy binge (not least because it has hobbled the once-proud, independent, capable civil service: & this was Thatcher's doing), so we're with you there

I don't doubt your legal requirement point - it's an appalling tangle of bad laws, lazy intellects and statist reflexes (& in a pessimistic moment one wonders whether green coalition ministers are up to the task of sorting it)

no disrespect to yours or anyone's nearest & dearest: none of us can do any more than play the team they put in front of us, so to speak

but as noted to budgie, jim & anon above, I am not commenting on the competence of said staff, or indeed their payscales or hours of work, merely that (a) they are predominantly middle class; (b) they are in the firing line; (c) it is not just the recipients of discontinued services that will complain - it will also be the cash- beneficiaries !

Be careful what you ask for..if you get rid of all the NHS admin staff who do you expect to keep all the records - Nurses & Doctors????. Is the NHS really more inefficient than say a bank or a typical UK plc? I think not. Visit a typical FTSE 100 company and see legions of "Consultants" and "Contractors" doing jobs that permanent members of staff are meant to do but cant be asked.....with interest rates at near zero percent it would be incredible if any financial services firm made a loss, but they still consider themselves "Masters of the universe" 'cos they get in a 7am and leave at 9pm. Which reminds me, the elephant in the room is the widespread drug use in the city of London. Traders, Bankers, support staff managers all high on something to keep them alert all day.....

"My observation of the NHS is that they actually over-rely on the dedication of low paid admin staff, and I'm not sure that will survive yet more changes. In fact my observation is that it is the willingless of some "middle-aged, middle-class ladies" to work at lower than market pay that keeps a some of the NHS going. But maybe elsewhere in the NHS, like London, it is different."

Absolutely! At the GP surgery where I have rented a room for 15 years I have watched this. When I started I got a full reception service. The surgery won "investors in people" every year. The nice middle aged ladies enjoyed their jobs, there were three of them on reception and twice that in the office. It was a happy place. Then as the staff left they would not be replaced. Now there is only one woman on reception and you are expected as a patient to manage without her and book yourself in on a machine. (She sits at a computer with her back to the reception). The staff is skeletal and stressed. My receptionist long since transferred to other duties. One woman asked for a pay rise to acknowledge all the extra work she was now doing and was told "You don't work for the NHS for the money" (says the Porche driving practice manager)

No wonder notes get lost. Nobody knows who files them any more since Janet/Sally left.

@ND, BE, SumoA big legal cost for the UK is the ambulance chasing laws (no-win-no-fee), which don't exist in the EU.

There was talk to repealing this law, but I haven't heard the plans for getting rid of it.

@sumo...awful situation that if you are a proper granny bashing criminal the taxpayer picks up the tabHaving a defence lawyer is a corner stone of our legal system (and in the EU/US etc). Without it too many innocent people will be found guilty. The system needs to be fixed so if you commit a crime you actually end up doing time.

I think this is partly due to the educational system where the abstract and mental - where there is no reference to the untidy world seems to be highly prized. We grow with an unconscious bias that the Germans do not seem to have.

(he said having specialised in topological spaces in the last year of his maths degree :)

Today I rang the council to ask about trade waste licences. I only wanted to know how much they were and what they covered.

I spoke to the receptionist who transferred me to a nice a lady who took a message but was no more than an expensive answering machine for the man who could answer my question. He was at lunch and considered himself terribly important as he had a secretary and was called a liaison manager.

He still hasn't phoned me back, neither has she. What exactly are we paying either of them for, if neither of them can work out how to put this on a website?

Many of the NHS female managers are former nursing staff whose nursing qualifications are treated as a degree and thus give them a level of status in the public sector that their experience and knowledge would not give them in the private sector. Hence they pick up many of the lower managerial positions, including the many communications, HR, planning etc jobs. Look at most NHS trusts and SHA's and you will find lots of former nurses, usually the bossy ones.

Alex, I'm quite puzzled what would motivate nurses to switch into non-nursing management, as the pay is usually lower, sometimes the same, as a good nurse gets.

Even a specialist management job, like HR Team Manager that would require that a nurge get a professional HR qualification, is on the same band as "Nurse Advanced" (Band 7) in the official NHS job description scheme.

An ordinary starting grade nurse (Band 5) is paid more than a General Office Manager (Band 4), and the same as a Procurement Officer or Communications Officer (Band 5).

Is it nurses that desperately want to get a 9 to 5 job, or have back problems etc that stops them nursing, moving sideways for the same or less pay?